Find and compare the best Provider Data Management (PDM) software in 2024
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Use the comparison tool below to compare the top Provider Data Management (PDM) software on the market. You can filter results by user reviews, pricing, features, platform, region, support options, integrations, and more.
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CredentialStream
HealthStream
161 RatingsCredentialStream® incorporates patented technology that provides everything necessary for requesting, gathering, and validating information about a provider, all to establish a reliable Source of Truth for downstream processes. With a modern platform that is continuously updated, along with best-practice content libraries and industry-leading data sets, CredentialStream stands out as the most comprehensive provider lifecycle management solution available. -
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Collaboration for patient care requires constant connectivity. It is important to simplify how you exchange this information with your payers. Availity makes it easy for payers to work together, from the initial check of a patient’s eligibility to the final resolution of your reimbursement. You need quick and easy access to information about your health plan. With Availity Essentials, a free, health-plan-sponsored solution, providers can enjoy real-time information exchange with many of the payers they work with every day. Availity Essentials Pro, a premium, all-payer option, is also available to providers by Availity. Essentials Pro can improve revenue cycle performance, reduce claim rejections, and help to capture patient payments. So you can concentrate on patient care, Availity will remain your trusted source for payer information. Providers can integrate HIPAA transactions into their PMS through our electronic data interchange (EDI), clearinghouse, and API products.
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Medallion
Medallion
Medallion is the first solution for healthcare companies to fully offload their clinician operations—state license management, payor enrollment, credentialing, and more—in one modern management platform. Since inception in 2020, Medallion has saved over 100,000 administrative hours for leading healthcare companies like Cerebral, Ginger, MedExpress, Oak Street Health, and hundreds more. -
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Certify
Certify
Certify provides API-first licensing, credentialing, and enrollment to payors and health systems as well as rapidly-growing digital health companies. We provide insights and enable organizations to achieve high performance. Our one-click credentialing solution helps you build best-in-class provider network. Automated, real-time NCQA-compliant credentialing for scaling provider networks. Automated monitoring to ensure compliance of provider networks. We take the guesswork and paperwork out of licensing so you can scale to new markets seamlessly. You can join the network to get reimbursed quicker so you can get back on your feet. Streamlined processes to cross-state licensure for all license categories in all 50 US states. Streamlined enrollment for payers to allow providers to be in-network in new market. Our dashboards allow you to track enrollment progress. Our best-in-class method will clean, normalize, or enhance your provider data. -
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CAQH
CAQH
CORE brings together the industry to accelerate automation and develop processes that streamline healthcare services for patients, health plans and providers. CAQH, a healthcare organization's trusted source of member and provider data, helps reduce costs, improve payment accuracy, and transform business processes. In an ever-changing healthcare landscape, it is vital to improve payment and claim processing systems. The new and updated CAQH CORE operating rules represent a significant advance in our ongoing efforts to improve efficiency. -
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Madaket
Madaket Health
Our automated solutions will give you back hours of your day, and millions in your pocket. You can access the key players - providers, payers and partners - as well as the real-time accurate data that you need to ensure that care delivery is never missed. We handle all the complicated connections across thousands payers. Here you will find all the information you need for a fast and easy registration to any payer. Cloud computing has never looked so good. Central command to manage and store provider data in real time, connected everywhere. Provider verification made simple. Our platform will process your request quickly. -
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iICE Enterprise Edition
Innovit
Innovit's iICE Training programs are designed to provide relevant knowledge and skills for your employees. You can be sure that your team will continue to improve their systems and processes for the sustainable management master data by incorporating 'best practices' in product information management. Innovit is a global provider of solutions that specializes in MDM (Master Data Management), PIM [Product Information Management], GDSN (Global Data Synchronization), UDI Compliance, Unique Device Identification (Unique Device Identification), and NPI Workflow Automated software. -
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Model N
Model N
Model N is an end-to-end platform that empowers companies to maximize their revenue by transforming Sales, Marketing, Channels and Finance. Model N's revenue management solutions can help you maximize your revenue by turning tactical, siloed activities into strategic, end-to-end revenue processes using automation and intelligence. Revenue Cloud bridges the gap between back-office and front-office activities, providing a single system of record for all revenue execution. Customers can easily set up and quote complex products, quickly reach terms on complex contracts, have better channel data, which allows for visibility into channels and efficient management of incentive programs, avoiding overpayments. Model N Rebate Management allows you to better engage your channels and maximize revenue. -
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Kyruus Connect
Kyruus Health
Health systems can match patients to the right providers, optimize patient access, and manage data with industry-leading solutions. Our provider search and schedule solutions, built on the Kyruus data management platform, enable health systems to optimize matching between patients and providers; boost patient acquisition and convert; and deliver a consistently positive patient experience at key points of entry. Create a digital presence that is unique with a modern access experience for patients. This allows them to easily find the best care options and book online. By equipping your agents with the necessary technology, you can connect consumers with the best providers via your call center. Providers and staff will be able to see the providers in your network, and patients can leave their appointment knowing that the next one is already booked. -
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CodySoft
Cody
The burden of CMS and state regulations in the health care industry creates challenges for time and money. Health plan members communicate with compliance directors every day, despite the fact that outdated processes and anxiety about not meeting regulatory compliance are common. It is time to centralize and have control over your organization's compliance program, and the entire process of creating material. CodySoft®, a web-based suite of software products, is designed for health plans and their complex environments. Project management of provider and member marketing materials is more efficient and cost-effective. Increased accuracy and reduced regulatory compliance risk It is easy to manage investigation issues. Access your dashboard online via a secure portal without any IT integration. You can easily generate reports for regulatory audits or metrics tracking. You can see real-time updates. -
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HealthEC
HealthEC
HealthEC's best platform for population health management, which includes our CareConnect™, and our analytics module 3D Analytics™, is designed to improve quality of care and patient experience and overcome the most difficult data challenges in the healthcare industry. A universal data warehouse that contains normalized claims, clinical, SDoH, and other data from all sources will help you conquer system chaos. CMS certified for reuse. Integrate, customizable care plans, decision support tools, and robust care management support can eliminate workflow disruption. Integrate community resources and address social determinants of healthcare to provide patient-centric care. Clear dashboards or at point of care provide actionable insights that inform strategies at the provider, provider, practice, organizational, and patient levels. Enhanced MCO performance reviews, compliance with the CMS interoperability rules. -
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Rhapsody
Rhapsody
Build the interoperability solution you need. Rhapsody is a flexible toolbox which allows your team to adapt to any modern environment. Rhapsody helps you provide the highest level service by ensuring healthcare data flows where, when and how your unique environment requires. Create flexible solutions for every connection requirement. Streamline workflows using a solution that's infinitely configurable, and specifically designed for healthcare. Create intricate integrations using a robust toolkit, which has been tested around the world. The platform has customers in 36 different countries. Create FHIR interfaces that are cutting edge with ease and simplicity using REST and FHIR specific JSON. Security is a primary concern, and is built into the entire product. This is to protect any protected health information that passes through the engine. -
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symplr Provider
symplr
symplr's provider credentialing software creates a single source for data on providers, reduces turnaround times and shortens revenue cycle, all while prioritizing the safety of patients. Symplr's Provider Credentialing Software makes data collection, secure access, report generation, and ongoing compliance easier for providers, credentialing personnel, and internal approval panels. Our customers report a reduction of 20% in credentialing timelines and a 50% reduction in meetings with committees. In one automated, user friendly hub, you can collect, verify, store and share documents and data related to the provider lifecycle. This will save time and reduce costs. You can easily enroll payers with providers and track applications step-bystep using the built-in module. Automate the collection of data from hundreds primary sources, including DEA, SAM and NPDB. -
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symplr Payer
symplr
A unified, automated solution for provider data can help you save money, eliminate data silos and provide better outcomes for your members. symplr pays provides a unified source of truth that is always reconciled with primary sources. It improves data access, transparency, and quality. It also eliminates the need for multiple requests for information and reduces frustration among providers. Payers can use symplr as the enterprise-wide hub to feed accurate and timely information to downstream systems by using symplr as the enterprise data hub. Our end-to-end, highly configurable provider data management solution handles all pre-contract and contract renewal negotiations. Standardize and streamline contracting processes while capturing contract information such as sentinel event, trigger dates and configuration efforts. The unique design of symplrPayer allows your organization's contracting and credentials to be consolidated. -
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Verisys
Verisys
Verisys has been credentialing events for more than 2 million healthcare organizations in the United States annually, for over 30 years. Our provider credentialing service will keep you compliant. Credentialing is a complex task for health plans, health systems, and hospitals. Physicians may be licensed in more than one state and provide telehealth across state borders. This requires licensing verification with each state board, and compliance with the unique regulations of that state. Due to the fact that physicians may have the same maiden name, alias name, nickname, or abbreviated name, identity matching can be difficult. To get an accurate picture, every physician must be screened and their credentials checked against thousands of primary sources. We can assist you with anything from a simple search for provider credentials to implementing an end-to-end credentialing system. -
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Change Healthcare
Change Healthcare
Our platform provides consistency, continuity and scalability throughout our integrated portfolio. This allows our customers to improve operational efficiencies, decision-making and patient outcomes, while enabling innovation in our evolving healthcare system. Change Healthcare's platform, which combines innovative data and analytics with patient engagement and collaboration features, helps payers and providers optimize workflows, get the right information when they need it, and provide the safest, most clinically appropriate healthcare. We facilitate data interoperability and access to data to support CMS patient interoperability and access rules. We also enable real-time clinical document access to better manage risk adjustments, improve HEDIS score, and support accurate payment with faster adjudication. -
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TriZetto
TriZetto
Accelerate payment and reduce administrative burdens. Our claims management solutions, which have a network of 8,000+ payers and a long-standing partnership with 650+ practice managers, can lead to fewer pending cases and less manual intervention. Transmit professional, institutional dental, workers compensation, and other claims quickly and accurately for fast reimbursement. Provide a simple and seamless financial experience to meet the shift towards healthcare consumerism. Our patient engagement solutions enable you to have informed discussions about eligibility and financial responsibility, while reducing obstacles that could impact patient outcomes. -
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SKYGEN’s Provider Data Management is a solution on-demand that helps healthcare payers improve provider network management. PDM improves payers' abilities to build effective provider networks, improves member and provider satisfaction, and lowers administration costs. It's an intelligent solution that helps payers meet the needs of today’s tech-savvy healthcare constituents. Reduced contract acquisition costs through fast, efficient and paperless provider recruitment, as well as supplemental network rental. Online credentialing reduces credentialing costs while improving provider satisfaction. Automating provider self-verification, and ensuring accurate provider data for online directories, will eliminate expensive outreach. SKYGEN provides dental and vision connectivity services that empower clients to confidently move into the future.
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Overview of Provider Data Management (PDM) Software
Provider data management (PDM) software is a type of software designed to help healthcare organizations manage records and information related to their patients and providers. It is used by hospitals, clinics, laboratories, physician offices, insurance companies, health plans, and other healthcare providers for gathering and maintaining patient information. PDM software helps to ensure that the most up-to-date version of patient information is available throughout the organization.
When it comes to managing provider data, one of the biggest challenges faced by organizations is ensuring accuracy of data received from patients or other providers. This makes it difficult for organizations to create a unified view of all patient encounters and history across multiple sites and providers. To address this issue, many healthcare organizations are now turning to PDM software solutions that make it easier to capture accurate provider data in real time from different systems as well as providing secure bi-directional synchronization with external sources such as insurance companies or remote care workers.
The main goal of PDM software is to improve the quality of care provided by allowing healthcare providers access to complete information about a patient’s past visits or treatments at any time. The use of PDM software also reduces costs associated with inefficient manual processes needed for entering and maintaining provider data as well as eliminating duplication errors due to outdated or incorrect records.
PDM usually integrates with existing electronic medical record (EMR) systems within an organization so that all changes made in one system can be automatically reflected in another if they are related. With this capability, new information captured through EMRs can be quickly reflected in other parts of the network where relevant without having to manually enter duplicate copies into each system separately. This also allows different departments within an organization to easily share up-to-date patient details at all times which improves workflow efficiency while reducing paperwork requirements for staff members working on multiple cases simultaneously from various locations.
Additionally, some modern PDM systems offer additional features such as automated alerting when changes occur on certain types of records; automatic visit tracking capabilities; analytics tools for analyzing clinician performance; reporting tools for generating detailed reports on patient outcomes; advanced search capabilities for quickly locating patient records based on specific criteria; multi-level security measures protecting sensitive data stored within the system; audit trails showing who accessed what when; customizable workflows tailored according to individual user requirements; ability to connect with external sources such as billing systems, etc.
Overall, PDM software can play a key role in improving data accuracy while helping healthcare professionals better manage their patients' encounters across multiple sites and provide cost effective treatment plans resulting in quicker recovery times for those affected by disease or illness.
Why Use Provider Data Management (PDM) Software?
- Streamline Data Collection and Management: Provider data management (PDM) software helps streamline the process of collecting, organizing, and managing data related to healthcare providers. By automating key processes, such as collecting information from various sources and updating records in an organized fashion, PDM systems reduce manual effort and help save time.
- Improve Accuracy: PDM software also helps ensure accuracy by eliminating data entry errors caused by manual input or miscommunication between different departments. The software uses standardization tools to ensure that all fields adhere to industry guidelines for quality assurance. By having accurate and reliable data on providers in a single platform, it becomes easier for organizations to visualize patterns and draw conclusions when it comes to patient care decisions or other operational needs.
- Consistent Compliance with Regulations: Storing provider profiles in an electronic system can help healthcare organizations remain compliant with regulations that require them to regularly seekspecific pieces of information about each provider they work with. Moreover, PDM systems come with built-in security protocols that protect sensitive patient information against unauthorized access through encryption technologies.
- Automated Reports: Generating reports from scattered pieces of paper is a long and tedious job; but a good PDM system simplifies the process significantly by allowing users to generate detailed reports on providers using just a few clicks as well as automate report generation based on predefined parameters according to your organization's specific need without any manual intervention required saving time spent on mundane reporting tasks.
- Boost Productivity: Additionally, PDM systems eliminate duplicated efforts by taking advantage of automation capabilities already available within existing databases used by the organization making it easier for staff members across multiple departments to look up or update provider profiles quickly reducing delays when needed information isn't readily available due to manual paperwork which can have an overall impact on productivity levels within the organization.
Why Is Provider Data Management (PDM) Software Important?
Provider Data Management (PDM) software is an increasingly important tool for healthcare organizations. The complexity of managing patient data, physician information and other provider data makes PDM an invaluable asset to a healthcare organization’s operations.
The sheer volume of provider data that must be managed on a daily basis can be overwhelming without the help of PDM software. This type of system simplifies the task by streamlining processes and reducing the number of manual steps required to manage data properly. It also ensures accuracy and consistency in all provider-related data, which is essential in a highly regulated industry like healthcare.
PDM software enables efficient coordination between providers and various departments within a healthcare organization. When properly integrated with existing systems such as Electronic Medical Records (EMR) or Healthcare Information Exchanges (HIE), it helps ensure key details such as patient demographics are correctly documented and quickly shared across different departments for better treatment protocols and outcomes.
Further, PDM software can expedite quality assurance activities with detailed analytics on provider performance. This allows administrators to more easily identify any gaps in quality control or compliance issues which could lead to audits or disciplinary action from governing agencies like CMS (Centers for Medicare & Medicaid Services).
Finally, missing or inaccurate provider data can significantly impact billing cycles as well as payment claims processing both from insurers and patients alike, causing significant revenue losses due to delayed payments. With PDM Software this complication can be avoided through automated updates which reduce errors stemming from manual inputting while helping boost overall profitability with accurate invoicing processes across multiple departments.
In summary, Provider Data Management Software is critical for any healthcare organization looking to reduce operational complexity while increasing quality assurance adherence along with improved financial stability due to better billing cycles enabled by automated updates & filing procedures offered through these systems.
Features of Provider Data Management (PDM) Software
- Workflow Automation: PDM software allows for automation of tasks such as setting up new products, materials or components in a database and reassigning resources within the system. This means that changes to product details can be made quickly and accurately, ensuring that all data is updated in real-time.
- Version Control: PDM software provides version control capabilities which allow users to track changes to projects over time, as well as detect any discrepancies between different versions. This helps companies ensure that the latest version of their products is always accurate and up-to-date.
- Document Management: PDM software enables documents and files associated with a particular project or product to be stored securely within one central repository or database where they are easily accessible by authorized personnel. This helps streamline document retrieval times and ensures consistent accuracy across all versions of products or services stored within the system.
- Security & Accessibility: PDM software also helps companies secure highly confidential data from unauthorized access by enforcing strict user authentication processes such as two-factor authentication or biometric authentication methods depending on the security requirements set out by the organization itself. The software also offers granular access levels so users can view only certain areas of information they need while preventing them from accessing other parts of an organization’s project database.
- Data Analysis Capabilities: With its integrated analytics capabilities, PDM software offers business intelligence tools which help organizations monitor trends related to their projects, performance metrics, customer feedback, etc., allowing them gain insights from their own data and recognize opportunities for improvement more effectively than ever before.
- Reporting: PDM software also helps in generating comprehensive reports which provide users with up-to-date information on the current status of a project, along with metrics related to its progress over time. This enables companies to quickly identify any potential problems or areas that might need additional attention and take corrective action, if necessary.
What Types of Users Can Benefit From Provider Data Management (PDM) Software?
- Healthcare Providers: PDM software can help healthcare providers streamline their workflow, improve patient care, and make it easier to store and access medical records.
- Health Information Technology Professionals: PDM software helps health IT professionals manage electronic health records (EHRs), create reports, and run accurate billing analyses.
- Insurance Companies: PDM software allows insurance companies to verify claims, track payments, and more quickly process reimbursements.
- Pharmacies: Pharmacies can use PDM software to easily look up drug prices, track inventory levels, and refill prescriptions quickly.
- Patients: With PDM software, patients can view laboratory results online in real-time, save time at the doctor's office by completing forms electronically ahead of time, and connect with their health care providers from anywhere.
- Researchers: Research teams can utilize data management tools to collect information about medical treatments used for clinical trials or other studies in order to draw conclusions about the outcomes of different therapies.
- Government Agencies: Government agencies such as Medicare or Medicaid rely on PDM software to monitor compliance with regulations for healthcare providers who submit requests for reimbursement through them.
- Public Health Analysts: PDM software can help public health professionals track the spread of diseases, monitor healthcare trends, and develop new policies.
How Much Does Provider Data Management (PDM) Software Cost?
The cost of provider data management (PDM) software can vary widely depending on the type and scope of services you need. Generally speaking, the price tag for PDM could range from a few hundred to several thousand dollars per month, with customizations and add-ons costing extra. Most providers offer service packages that include standard features such as secure cloud hosting, access to comprehensive provider directories, claim adjudication systems, search functionality, and reporting/analytics tools. These basic components tend to make up the bulk of the cost. Additionally, users typically pay fees for initial setup or customization and any extra modules they select such as credentialing or accounts receivable functions. To ensure you receive value for your money when selecting PDM software, it is best to research options thoroughly beforehand and review customer reviews whenever possible.
Risks To Consider With Provider Data Management (PDM) Software
- Security Breaches: Provider data management (PDM) software stores critical patient information. As a result, there is an increased risk of confidential records being breached and falling into the wrong hands. Without proper security measures, it can be difficult to protect confidential data from cyber-attacks or unauthorized access.
- Privacy Issues: PDM software contains sensitive personal information which if compromised, can lead to significant privacy and legal issues for healthcare providers. Improperly configured systems could cause exposure of private patient data or expose the provider to fines and sanctions from government regulations.
- Data Loss/Inaccuracies: Data loss due to hardware failure, user errors, power outages, or other unforeseen events are risks associated with PDM software. Additionally, incorrect data entry and human error can lead to inaccurate records being maintained in the system which could become costly in terms of reputation damage as well as financial losses.
- Compliance/Regulatory Issues: Many countries have strict laws governing how healthcare data should be collected, stored and shared between different parties involved in providing care services. If a provider does not adhere to these guidelines they could face stiff penalties including fines and potential lawsuits as a result of non-compliance with regulations governing medical recordkeeping practices.
- Cost: Installing and maintaining an effective PDM software requires significant investment in both technology and personnel. Additionally, the cost for updating the system regularly to meet changing needs of providers must also be considered.
Provider Data Management (PDM) Software Integrations
PDM software can integrate with a variety of different types of software. This includes Enterprise Resource Planning (ERP) systems which are used to manage and monitor business processes in various departments such as sales, accounting, purchasing, production, and inventory management. It can also be integrated with Customer Relationship Management (CRM) systems which are used to track customer interactions across multiple channels and provide insights into customer behavior. Additionally, PDM software can be connected with document management systems for the storage and collaboration of digital documents. Last but not least, PDM software can also work with other business applications such as accounting/financial reporting systems or ecommerce platforms. By integrating various software systems, businesses can benefit from the insight provided by combining data from relevant sources and create more streamlined operations.
Questions To Ask Related To Provider Data Management (PDM) Software
- What are the security and privacy features of the PDM software?
- Does the PDM software support data encryption and access control?
- How easy is it to set up, configure, and manage data within the PDM system?
- Is there a feasible way to integrate existing applications with the new PDM system?
- Is there a cost-effective solution for managing large volumes of data within the system?
- How often do updates need to occur for the software in order to ensure maximum performance and security?
- Is there customer service available for troubleshooting issues or technical difficulties related to using the software?
- Does this particular PDM come equipped with analytics capabilities that can help organizations identify trends or improve decision making based on their data usage?
- Are there any additional costs associated with properly maintaining or managing the system (i.e., consulting fees, installation charges, etc.)?